Alcohol and severe mental illness

It’s safest to not drink at all while you’re planning a pregnancy but if you’re finding this hard, there’s lots of help available.

When you drink, alcohol passes from your blood through the placenta and to your baby. If you are trying for a baby you can become pregnant very quickly and if you are drinking there is a chance that you will be drinking when you are pregnant.

This is why it’s best to stop drinking alcohol if you are having sex and not using contraception.

Mental illness and alcohol

Drinking alcohol and depression are linked. Some people with mental illness use alcohol to help them feel better. It might make you feel better for a little while but heavy alcohol use makes you feel worse in the long run.

Regularly drinking alcohol makes depression more likely. 

As well as making you more depressed, drinking alcohol to feel better can also make other problems worse. For example, it can leave you unable to take care of children, which makes you feel worse about yourself, which can make you want to drink to forget.

This leads to a vicious cycle.

You may start to be addicted on alcohol and crave it more and more.

If you know you are already addicted to alcohol, please scroll down for support.

Alcohol or antidepressants?

Alcohol is not safe in pregnancy. Some people think that using alcohol is safer than taking antidepressants in pregnancy but this isn’t true. If you’re drinking too much, it can harm your health, your baby's health and make your mental illness worse. 

If you are worried about taking antidepressants or other mental health medication always speak to a doctor about it. They will work with you towards a suitable treatment that is best for your health and your baby's health.

Find out what you would talk about in an appointment with your doctor about planning a pregnancy.

Find your triggers

It can help to think about what triggers your drinking.

Triggers are things that make you want to do something (like smoke, drink or take drugs). Often they are based on habit.

For example, every Friday you have a drink after work. The alcohol makes smoking feel like a good idea, so you smoke as well.

  • The first trigger is the end of the week.
  • The second trigger (for smoking) is drinking alcohol.

Once you've worked out your triggers, see how you can change your life to avoid them. 

For the example above you could find another activity to do after work on Friday, maybe make it movie night with a friend instead of a pub.

Or, if you really don't want to give up the social occasion, make a conscious plan about what to drink when you are in the pub on Friday. 

The charity We are with you has more information on triggers.

How can I get help to stop drinking?

Some women know they are drinking too much but don't feel able to talk about it.

Cutting down or stopping on your own can be difficult, and you may need help. Talk to your GP - or midwife if you have one. They won't judge you and they can put you in touch with more support if you need it.

They may give you the name and phone number of a midwife or doctor who specialises in caring for pregnant women who are drinking too much.

Your midwife or doctor should be able to help answer any questions you may have about how your drinking may affect your pregnancy. For example, whether your baby is likely to need any extra medical care when they are born.

They can also help you cope with difficult feelings you may have about your drinking. Let them know if you need any help with your antenatal appointments, such as text reminders or help with transport.

If you depend on alcohol and get withdrawal symptoms when you don’t have a drink, it’s important to get medical help to gradually cut back. 

Don’t stop drinking suddenly without speaking to your doctor, midwife or local alcohol treatment service as this can be dangerous.

Signs that you depend on alcohol may include:

  • having a strong desire to drink
  • carrying on drinking even when you know it’s harmful
  • losing interest in other activities.

Withdrawal symptoms may include:

  • shaking
  • sweating
  • feeling sick
  • feeling anxious.

If you have other children at home, you might sometimes struggle to look after them properly. But there is help available. If you or your children already have a key worker, or a children’s worker, you can ask them to regularly check in on how you are all doing. If not, your midwife can offer you advice and help.

Getting support with giving up alcohol

If you’re finding it hard to give up alcohol, talk to your mental health team, GP, midwife or pharmacist. They will not judge you and will want to support you.

  • You can also get free specialist support from your local alcohol treatment service – you can find contact details for services in England here. You can also find details of support organisations in Scotland, Wales and Northern Ireland.
  • Drinkline is the national alcohol helpline. If you're worried about your own or someone else's drinking, call this free helpline on 0300 123 1110 (weekdays 9am - 8pm, weekends 11am - 4pm).
  • Alcoholics Anonymous (AA) is a free self-help group. Its 12-step programme involves getting sober with the help of regular support groups.



[1] National Institute for Health and Care Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors: Information for the public. Clinical guideline [CG110]

[2] National Institute for Health and Care Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors: Information for the public. Clinical guideline [CG110]

[3] National Institute for Health and Care Excellence (2011) Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence. Clinical guideline [CG115]

[2] Hunt  GE et al. (2019) Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews Issue 12. Art. No.: CD001088. DOI: 10.1002/14651858.CD001088.pub4.

[3] National Institute for Health and Care Excellence (2018) Clinical Knowledge Summary: Alcohol - problem drinking.!topicSummary

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